Comparison of the Linked Color Imaging (LCI) technology and chromoendoscopy with acetic acid for diagnosis of Barrett's esophagus

Objectives:

LCI is a new imaging technique based on 4 independently acting LEDs that is enhancing the mucosal vascular pattern and surface pattern morphology. To date, chromoendoscopy with acetic acid is considered the gold standard for diagnosis of Barrett's esophagus.

Aims:

The aim of this prospective study was to evaluate the recently introduced LCI technique compared to conventional dye spraying with acetic acid for diagnosis of Barrett's esophagus.

Material & Methods:

Consecutive patients with Barrett's esophagus were categorized according to the Prague classification and prospectively included. All Barrett segments were carefully evaluated by using high-definition white-light imaging, followed by LCI and acetic acid spraying. At each examination targeted biopsies were taken from all visible lesions, followed by random four-quadrant biopsies were applicable.

Results:

The diagnostic yield of conventional dye spraying was significantly higher for diagnosis of Barrett's esophagus compared to high-definition white-light endoscopy (P < 0.05). Of note, no significant difference for diagnosis of Barrett's esophagus was noted between acetic acid chromoendoscopy and the LCI technique. LCI diagnosis was always consistent to traditional dye spraying (100% concordance). The random four-quadrant biopsy protocol did not add any new information to the one already obtained by using LCI.

Conclusion:

The newly introduced LCI technique is superior to high-definition white light endoscopy for diagnosis of Barrett's esophagus and equally effective to acetic acid dye spraying. Therefore, the LCI technique has the potential to facilitate the diagnosis of Barrett's esophagus and to overcome the limitations of a random 4-quadrant biopsy protocol.